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D C Martin

Publications and source records attributed to D C Martin.

At least 163 records · Page 9Linked to original sources
PubMed1986

Clinical results of terminal salpingostomy with the use of the CO2 laser: report of the Intraabdominal Laser Study Group.

Forty-eight women underwent terminal salpingostomies with a standard operative procedure with the use of the CO2 laser and microsurgical techniques at five centers. Early second-look laparoscopy was performed in all patients 1 to 12 weeks after the laparotomy. The tubal patency rate at the second look was 92% for these 48 patients, with a minimum of 6 months' follow-up study in all patients. Of these patients, ten became pregnant (21%), one with an ectopic pregnancy (10%). All pregnancies occurred within 12 months of the second-look procedure. It is preliminarily concluded from this series that use of the CO2 laser for neosalpingostomy at laparotomy with early second-look laparoscopy provides a term pregnancy rate similar to that previously achieved by nonlaser microsurgical techniques and shortens the time period between the surgical procedure and when conception would be expected to occur.

Adult↗
PubMed1986

Evaluation of the rat renal allograft model in comparison to man: a physiological perspective.

Fabre has previously questioned the rat kidney allograft model from an immunologic perspective and raised some important considerations. The present study addresses further the fidelity of the rat renal allograft model from a physiologic rather than immunologic perspective. We reviewed several rat renal allograft studies from several laboratories, including our own, that followed BUN or urea levels during renal failure. Also examined were several studies from the literature concerning patient survival and uremia. The percentage of patient and rat survival was plotted against maximal BUNs attained. The frequency of survival was significantly (p less than 0.05) increased in the rats by comparison to the patient population over a range of median BUNmax values. Additional human data that were utilized for analysis included a group of 16 patients who experienced renal failure and subsequently chose not to undergo dialysis. Comparing the mean BUN at death in rats from our laboratory to this patient population, we found that there was a significant difference (p less than 0.001, 292 +/- 142 mg./dl. versus 127 +/- 51 mg./dl., respectively). When all of the rat data was combined, including results from the literature, and compared to the patients, a significant (p less than 0.001) increase in BUN at death was confirmed (204 +/- 95 versus 127 +/- 51, respectively). We also found that 82% of the rats that died with uremia possessed BUNs greater than 200 mg./dl. at some time during their course. In contrast, only one of the 16 patients (6%) that died with uremia demonstrated BUN levels as great as this. Although the rats frequently (13%) went on to indefinite survival after experiencing high levels of uremia, the vast majority did not. We conclude that the rats exhibit superior ability to tolerate high concentrations of urea in comparison to man. However, as a group, they demonstrated little ability to sustain their uremic condition for prolonged periods. This latter consideration is of utmost importance, since most renal transplant studies base their conclusions on length of animal survival following organ allograft failure due to rejection. We feel this is a salient feature of the rat renal allograft model.

Animals↗
PubMed1986

Preliminary observations on the results of combined temporary 192iridium implantation and external beam irradiation for carcinoma of the prostate.

We treated 43 patients with adenocarcinoma of the prostate confined to the pelvis with a combination of staging pelvic lymphadenectomy, temporary implantation of the prostate with 192iridium and external beam irradiation. The procedure was relatively safe with low early morbidity. However, there were significant late complications. Of these patients 29 had needle biopsy of the prostate 1 year after completion of therapy and 15 demonstrated residual tumor. Clinical stage C and poorly differentiated tumors were not well controlled.

Adenocarcinoma↗
PubMed1986

Vancomycin.

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Child, Preschool↗
PubMed1986

Studying alcohol teratogenesis from the perspective of the fetal alcohol syndrome: methodological and statistical issues.

Alcohol is a teratogenic drug and the effects appear to be grossly dose related. The severest effects are observable clinically as the fetal alcohol syndrome and are associated with heavy prenatal alcohol exposure and a history of chronic maternal abuse of alcohol. Hypotheses for subtler behavioral effects associated with lower levels of exposure can be generated from observation of the behavioral effects in FAS. Behavioral effects associated with various levels of prenatal alcohol exposure in humans include poor sucking and poor habituation in the newborn, poorer mental and motor development in infancy, and attentional and reaction time effects at four and seven years of age. Human behavioral teratology studies are necessarily complex due to the large number of covariates that affect behavior, modify the effects of teratogens, and influence interpretation. Challenging problems exist in assessing exposure, outcomes, and covariates. Common to assessment of all these classes of variables are the multiplicity of measurement and the indirect nature of the measurement. Answering specific questions about timing and dose effects demands careful statistical modeling procedures and large, complex data bases. Large data bases and indirect measurement problems suggest factor analytic extensions of current regression methodology, which we have proposed in this paper.

Child, Preschool↗
PubMed1986

A survey of Campylobacter and other bacterial contaminants of pre-market chicken and retail poultry and meats, King County, Washington.

As part of a larger study to determine the flow of Campylobacter and Salmonella from food animals to humans during 1982-83, 1,936 swabs were collected for bacteriologic study from pre-market chickens, retail poultry, and other retail meats as well as from equipment and work surfaces used to process such foods. Of the 297 samples collected in a poultry processing plant, 56.6 per cent were positive for Campylobacter jejuni/coli (CJC), as were 23.1 per cent of the 862 retail chicken, and 17.2 per cent of the 29 retail game hen samples. CJC was found infrequently in retail turkey, pork, and beef samples. Contamination of retail and pre-market chicken with CJC appeared to increase as the week progressed, and in pre-market chicken, later in the day. Less than 5 per cent of the retail samples of poultry, beef, and pork were found to contain Yersinia or Salmonella. However, Salmonella was cultured from 14.8 per cent of the swabs taken from the processing plant with 68 per cent of 44 Salmonellas being isolated concurrently with CJC. Tetracycline resistance which was plasmid-mediated was the most common antibiotic resistance observed, and was carried by 23.8 per cent of all CJC isolates. Overall, 38.8 per cent of all CJC isolates were resistant to ampicillin, erythromycin, streptomycin, or tetracycline, either singly or in combination.

Animals↗
PubMed1986

Composite tissue (limb) allografts in rats. III. Development of donor-host lymphoid chimeras in long-term survivors.

Eight LEW rat recipients possessing long-term-surviving (206-701 days) LBN vascularized hind limb allografts (CTAs) were tested for donor-host lymphoid chimerism. The recipients received various cyclosporine (CsA) treatment protocols in order to induce indefinite CTA acceptance. Histological examination of long-term-surviving CTAs demonstrated normal-appearing bone marrow in the donor limb. Lymphocytes isolated from host hemopoietic tissues (peripheral blood and/or spleen) by ficoll-hypaque density gradient centrifugation were tested against LEW-anti-BN antisera. Comparisons were made to standard curves employing various known concentrations of LBN and LEW cell combinations. The level of lymphocyte agglutination (dependent variable) showed a significant (P less than 0.025-0.005) linear relationship to the concentration of LBN donor cells (independent variable) present. Lymphocyte suspensions isolated from long-term CTA host peripheral blood and/or spleen showed a mean of 19.7% (+/- 9.7-95% confidence interval) donor LBN mononuclear cells present. Thus, it appeared that lymphoid cells originated from, and/or were released from LBN donor bone marrow into the circulation, resulting in chimeric repopulation of hemopoietic tissues. The presence of donor immunocytes in these limb allograft recipients may have been beneficial, and thus could have helped contribute to the long-term CTA survival observed.

Animals↗
PubMed1986

CO2 laser laparoscopy for endometriosis associated with infertility.

Medical, surgical and combined therapy have been used in the treatment of infertility associated with endometriosis. The CO2 laser offers the advantage of precise excisional surgery at the initial laparoscopy and potentially avoids further surgery and medication. In 115 women in whom initial or follow-up laparoscopy revealed the presence of endometriosis, the CO2 laser was used to excise or ablate the endometriotic lesions. Fifty-five (48%) of the patients became pregnant, with 12-44 months of follow-up. These 55 patients have had 61 pregnancies. Forty-two (69%) were term, 7 (11%) are ongoing, 11 (28%) aborted, and 1 (2%) was ectopic. Twenty-three (68%) of 34 patients with endometriosis as the only infertility factor had 28 pregnancies. Thirty-two (40%) of the 81 patients with endometriosis associated with other infertility factors produced 33 pregnancies.

Adult↗
PubMed1986

Pathology of digestive organs in renal transplant recipients.

A necropsy study of the pathological findings in the digestive system of 19 renal transplant recipients revealed that gastrointestinal (GI), hepatobiliary, and pancreatic pathologies are common in renal transplant recipients. Fifteen of the 19 patients studied had GI pathology. Hepatobiliary pathology was the most common finding with all but one of the 19 cases exhibiting one or more abnormalities. Pancreatic abnormalities were less frequent with 11 patients demonstrating normal findings.

Adult↗
PubMed1986

Cardiovascular pathology in renal transplant recipients.

Various cardiovascular complications are among the major causes of mortality in renal transplant recipients. The authors examined the cardiovascular findings from necropsy of 18 renal transplant patients. All but three of the patients showed one or more pathological abnormalities. Five patients exhibited severe coronary arteriosclerosis with acute myocardial infarction with a history of myocardial infarction noted in four patients. In addition, one patient showed moderate and two showed mild coronary arteriosclerosis. Also prevalent were left ventricular (LV) hypertrophy (10/18), right ventricular (RV) hypertrophy (7/18), LV dilatation (4/18), RV dilatation (8/18), left atrial dilatation (3/18), and right atrial dilatation (6/18). Valvular abnormalities consisted of dilatations of mitral ring (1/18), pulmonic valve (2/18), and tricuspid valve (3/18). Pericarditis was found in two patients and aortic atherosclerosis in ten patients. Findings on routine chest roentgenograms and electrocardiograms did not always correspond with the anatomical findings noted on necropsy examination. The results demonstrate a marked increase in the incidence of various cardiac abnormalities in renal transplant recipients.

Adult↗
PubMed1986

Neuropsychological changes in a young, healthy population after controlled hypotensive anesthesia.

We investigated the effect of controlled hypotension during halothane anesthesia on brain functions as measured by neuropsychological tests. Anesthesia in 17 patients included controlled hypotension, whereas in another 27 patients hypotension was not induced during surgery for correction of facial abnormalities. Intraoperative EEG recording showed no significant changes in EEG power during the induction of hypotension. Hypotensive anesthesia was not associated with greater postoperative impairment than normotensive anesthesia. Both groups did show short-term postoperative impairment of memory and learning. For at least the first 24 hrs after administration of a general anesthetic agent such as halothane, there is interference with consolidation of memory. This impairment was not apparent in follow-up examinations 6 months later.

Adult↗
PubMed1985

Maternal barbiturate administration and offspring response to shock.

Gravid Sprague-Dawley-derived rats were injected SC twice daily with either 20 or 40 mg/kg pentobarbital sodium (PT), sodium phenobarbital (PH), or the same volume of the saline vehicle on days 9-21 of pregnancy. Pair-feeding was employed. Vital, developmental, and activity measures were obtained on the neonates and locomotor activity was measured from 3-10 months of age. Avoidance was measured sequentially in a shuttle box, and in an operant chamber beginning at 3 months of age. The PH-80 dams gained less weight over the gestational period, and PH-80 and PH-40 offspring had more neonatal deaths. These male offspring were hyperactive at maturity, and PH-80 rats were initially slower to escape experimenter-initiated shock. PT exposure caused transient neonatal and juvenile hyperactivity. PT rats performed more poorly on both the conditioned avoidance and Sidman shock schedules, and had significantly lower brain: body weight ratios at 1 year of age. All four drug groups outperformed the saline offspring on subject-initiated shock schedules (punishment). Sex of offspring was determined on postnatal day 4 and the sex ratio was shifted towards male births with both drugs relative to controls.

Animals↗
PubMed1985

Neonatal sucking as an outcome variable: comparison of quantitative and clinical assessments.

A quantitative neonatal sucking measure and a clinical neonatal sucking measure were significantly related to one another, but only the quantitative measure was significantly related to prenatal alcohol and nicotine exposure. The clinical measure did not provide adequate precision to warrant its recommendation as an outcome variable at moderate exposure levels.

Alcohol Drinking↗
PubMed1985

The use of lipid emulsion as an intravesical medium to disperse light in the potential treatment of bladder tumors.

An obstacle to satisfactory treatment of early bladder cancer with hematoporphyrin derivative-photoradiation therapy is nonuniform illumination of the bladder mucosa. This study was done to determine the characteristics and attenuation of laser light passing through the dispersion medium. Bladder simulation was achieved with the use of 5 different sizes of round-bottom flasks. Intralipid was the dispersion medium. For each flask, 6 different concentrations of the dispersion medium were used. An Argon ion laser was used to stimulate a dye laser at 630 nm. The laser was directed toward the center of the flasks via a fiberoptic cable and energy concentration at 7 different angles was measured. We concluded that the optimal medium was a 1:100 dilution of Intralipid with water, which produced an almost uniform dispersion of light on the walls of the flask. There is a linear correlation between power as measured at the fiber tip and the amount of radiation detected on the walls of the flasks. After determining optimal concentration of medium, we calculated the amount of time needed for a desired energy (Joules/cm.2) to treat a tumor. This calculation was based on the size of the bladder and the power as measured at the fiber tip. The results indicate it is possible to treat the entire mucosa of the bladder with a uniform dose of photoradiation energy.

Fat Emulsions, Intravenous↗
PubMed1985

Composite tissue (limb) allografts in rats. I. Dose-dependent increase in survival with cyclosporine.

The dose-response effect of cyclosporine on rat limb transplant prolongation was investigated across the LBN-to-LEW histocompatibility barrier. This composite tissue allograft model has been shown to represent a strong transplantation barrier. Median limb allograft survival times increased in a dose-dependent manner with low cyclosporine doses, and then reached a plateau at higher levels. The cyclosporine dose that produced half-maximal survival based on a 20-day treatment was only 3.7 mg/kg/day. Histopathology revealed that the rejection process was distinctly different in limb allografts treated with cyclosporine compared with non-cyclosporine-treated controls. Rejection appeared to be delayed or partly arrested in certain areas of cyclosporine-treated limb allografts. These studies represent an initial step in laying the experimental foundation for clinical transplantation of composite tissue allografts using cyclosporine-induced immune suppression.

Animals↗